What is the trachea?

The trachea, often called the “windpipe,” is the tube that brings air from the mouth and nose down to the lungs where it branches into smaller tubes entering the lungs. The trachea is made of C-shaped cartilage rings. The top portion of the trachea that does not have the cartilage ring is comprised of the dorsal tracheal membrane. Normally, this tube should remain rather rigid and open during inspiration and expiration.

What is a collapsing trachea?

Tracheal collapse can occur to the portion of trachea in the neck or the portion in the chest, or possibly both areas. During inspiration, the tracheal portion in the neck is more likely to collapse. During exhalation, the tracheal portion in the chest is more likely to collapse.

This collapse causes a “goose honk” sounding cough to develop and may be followed by hacking or producing some white foam that can be confused for vomiting. Try to get a few videos of what your dog is doing to show the vet, since your dog may not have an episode during their appointment.

During the normal breathing process, the pressure changes in the airway. In dogs with a collapsing trachea, this pressure change causes the top part of the trachea to depress down, narrowing the airway. There are 4 grades of tracheal collapse in dogs, with Grade 1 being a 25% reduction in tracheal lumen size, Grade 2 is 50% reduction, Grade 3 is 75% reduction, and Grade 4 is the most severe where the top of the trachea is basically laying on the lower portion, closing the airway.

Clinical Symptoms of Tracheal Collapse

Symptoms can vary depending on the grade of collapse. Symptoms can include:

• Goose honk sounding cough that is often triggered by excitement, eating or drinking, barking excessively, or pulling on the leash. Allergies and inhalation irritants like smoke can also induce the tracheal collapse cough.
• Exercise intolerance
• Cyanosis (blue discoloration to gums or tongue due to lack of oxygen flow)
• Collapse
• Rapid breathing rate
• Syncope (fainting)
• Respiratory distress

Obesity, heart disease, dental disease, brachycephalic airway syndrome and laryngeal paralysis are common concurrent diseases in dogs with tracheal collapse. Many dogs also have some sort of liver disease or dysfunction, and the correlation with liver issues and tracheal collapse is not understood.

How can my vet diagnose a collapsing trachea?

Your vet will perform a thorough physical exam of your dog. If you can, try to get a few videos of your dog coughing at home to show the vet.

Radiographs (x-rays) of the chest and neck are the likely next step. This can be difficult since your dog needs to cough at the exact same time as the radiograph is being taken. Normal radiographs do not exclude tracheal collapse as a cause for coughing.

You may need a referral to a specialty practice for fluoroscopy. Think of this as real time radiographs, so it’s a moving image. This allows the vet to see exactly what the trachea is doing over the course of a minute or longer. Fluoroscopy is more accurate than a still image like a radiograph that is just catching a single second of movement.

Bronchoscopy is considered the ideal test for diagnosing tracheal collapse, but this does require general anesthesia. This test involves putting a camera down into the trachea to visualize the collapse and collect samples to test for infection. This is often a test done at a specialty practice.

My dog has been diagnosed with a collapsing trachea. What do we do now?

Medical management is often the first step with dogs who have Grade 1 or 2 tracheal collapse. Avoid airway irritants like smoke. If your pet is overweight, work on weight loss to their ideal weight range. Be sure to discuss any diet and exercise plans with your vet. Walk your dog on a harness and avoid using a collar to deter compression of the trachea. Finally, steroids, bronchodilators and cough suppressants are common medications your vet might use to control the cough.

Dogs with Grade 3 and 4 tracheal collapse may need surgical correction, usually by a surgical specialist. There are rings that can placed around the trachea or a stent placed inside the trachea to hold it open.

Read more:

Kennel Cough

Congestive Heart Failure in Dogs

Heartworm Disease in Dogs and Cats

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